Abstracts
Résumé
Cet article examine la décision du gouvernement du Québec de rendre obligatoire la vaccination aux travailleurs des centres d’hébergement et de soins de longue durée en réponse à la pandémie de COVID-19. Il explore les arguments en faveur de cette mesure, tels que la protection des résidents vulnérables et la préservation des services de santé, tout en examinant les préoccupations liées à une possible pénurie de main-d’oeuvre, les droits individuels.
Mots-clés :
- vaccination obligatoire,
- travailleurs,
- CHSLD,
- COVID-19,
- éthique professionnelle,
- droits individuels,
- santé publique,
- débats éthiques,
- gestion de crise
Abstract
This paper examines the Quebec government’s decision to make vaccination compulsory for workers in residential and long-term care centres in response to the COVID-19 pandemic. It explores the arguments in favour of this measure, such as protecting vulnerable residents and preserving health services, while also examining concerns about a possible labour shortage and individual rights.
Keywords:
- mandatory vaccination,
- workers,
- CHSLD,
- COVID-19,
- professional ethics,
- individual rights,
- public health,
- ethical debates,
- crisis management
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Appendices
Remerciements / Acknowledgements
Nous sommes reconnaissants du soutien du Conseil de recherches en sciences humaines du Canada dans le cadre de ce partenariat international Imagining Age-Friendly “Communities” within Communities: International Promising Practices. Les résultats de recherche de cette subvention ne reflètent pas nécessairement les opinions du CRSH. Nous sommes reconnaissants à la Dre Tamara Daly, au Dr Sean Hillier et à la Dre Agnès Berthelot-Raffard pour leurs encouragements et leurs critiques toujours utiles.
We are grateful for the support of the Social Sciences and Humanities Research Council of Canada in this international partnership Imagining Age-Friendly “Communities” within Communities: International Promising Practices. The research results of this grant do not necessarily reflect the views of SSHRC. We are grateful to Dr. Tamara Daly, Dr. Sean Hillier and Dr. Agnès Berthelot-Raffard for their encouragement and helpful criticism.
Bibliographie
- 1. Allard E, Marcoux I, Daneault S, Bravo G, Guay D, Lazarovici M. La COVID-19 et les soins de fin de vie en centre d’hébergement et de soins de longue durée (CHSLD): protocole de recherche de type descriptif-explicatif dans deux régions différemment affectées du Québec. Sci Nurs Health Pract. 2021;4(1):1-12.
- 2. Gouvernement du Québec. Vaccination obligatoire des intervenants de la santé et des services sociaux contre la COVID-19. 2021.
- 3. Institut national de santé publique du Québec. Données COVID-19 par âge et sexe au Québec. 20 novembre 2024.
- 4. FSQ-CSQ. Enquête sur la performance des soins aux ainés/COVID-19 Un drame social évitable qui confirme l’importance du rôle de l’État. 2020.
- 5. Tovani F, Bragazzi NL, Martini M. Le régime d’indemnisation par l’État des dommages résultant des vaccinations obligatoires et des vaccinations recommandées en Italie et en France: profils historiques, éthiques, médicaux, normatifs et jurisprudentiels. Med Droit. 2017;2017(146-147):125-30.
- 6. Daniels N. Health care needs and distributive justice. Dans : In Search of Equity - Health Needs and the Health Care System. Boston: Springer; 1983. p. 1-41.
- 7. Hayward AC, Harling R, Wetten S, et al. Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ. 2006;333(7581):1241.
- 8. Ottenberg AL, Wu JT, et al. Vaccinating health care workers against influenza: The ethical and legal rationale for a mandate. Am J Public Health. 2011;101(2):212-6.
- 9. Zaffina S, Gilardi F, Rizzo C, et al. Seasonal influenza vaccination and absenteeism in health-care workers in two subsequent influenza seasons (2016/17 and 2017/18) in an Italian pediatric hospital. Expert Rev Vaccines. 2019;18(4):411-8.
- 10. Flood CM, Thomas B, Wilson K. Vaccination obligatoire des travailleurs de la santé: analyse juridique et politique. CMAJ. 2021;193(17):E629-33.
- 11. Cénat JM, Noorishad PG, Moshirian Farahi SMM, et al. Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis. J Med Virol. 2023;95(1):e28156.
- 12. Dolu İ, Turhan Z, Dilcen HY. COVID-19 vaccine acceptance is associated with vaccine hesitancy, perceived risk and previous vaccination experiences. Disaster Med Public Health Prep. 2021;17:e97.
- 13. Barsade S, Chatman J, Duckworth A, et al. COVID-19 Vaccination Uptake Behavioral Science Task Force: Final Report. Paper presented to Lee A. Fleisher, MD, CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality; 23 fevrier 2021.
- 14. Ma AC, Liu H. Navigating organizational mandatory COVID-19 vaccination policy. Physician Leadersh J. 2022;9(1):43-47.
- 15. Messier F. Québec reporte au 15 novembre la vaccination obligatoire des employés de la santé. Radio-Canada. 13 Oct 2021.
- 16. Grant K, Anderssen E. ‘We are in crisis mode’: PSWs on front lines of hard-hit nursing homes. The Globe and Mail. 8 Apr 2020.
- 17. Huang L, Huschka TR, Barwise AK, et al. Psychological reactance, misinformation, and distrust: A mixed methods analysis of COVID-19 vaccine uptake. J Clin Transl Sci. 2024;8(1):e48.
- 18. MacKay M, Thaivalappil A, McWhirter JE, Gillis D, Papadopoulos A. “There was a lot of that [coercion and manipulation] happening and well, that’s not very trustworthy”: a qualitative study on COVID-19 vaccine hesitancy in Canada. Rev Commun. 2023;23(3):165-82.
- 19. Herati H, Burns KE, Nascimento M, et al. Canadians’ trust in government in a time of crisis: Does it matter?. PLoS One. 2023;18(9):e0290664.
- 20. Doucet H. « Répondre à la vulnérabilité »: l’éthique et les CHSLD au temps de la COVID-19. Éthique Santé. 2020;17(3):142-6.
- 21. Gruben V, Siemieniuk RA, McGeer A. Health care workers, mandatory influenza vaccination policies and the law. CMAJ. 2014;186(14):1076-80.
- 22. Patel K. Resisting the needle: why I won’t have the flu jab. BMJ. 2011;343:d6554.
- 23. Montandon MC, Aubry R. Est-il éthique de procéder à une vaccination antigrippale systématique des résidents en institution de type EHPAD alors que seule une minorité du personnel soignant accepte de se faire vacciner? Éthique Santé. 2019;16(3):142-8.
- 24. Le Coz P. Éthique et vaccination. Études. 2021;4286:35-44.
- 25. van Delden JJ, Ashcroft R, Dawson A, Marckmann G, Upshur R, Verweij MF. The ethics of mandatory vaccination against influenza for health care workers. Vaccine. 2008;26(44):5562-6.
- 26. Carman WF, Elder AG, Wallace LA, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet. 2000;355(9198):93-7.
- 27. Carewest v. Alberta Union of Provincial Employees (Nasr Grievance). 2001;104 LAC (4th):240. A.G.A.A. No. 76.
- 28. Betsch C, Böhm R. Detrimental effects of introducing partial compulsory vaccination: experimental evidence. Eur J Public Health. 2016;26(3):378-81.
- 29. Moore R, Purvis RS, CarlLee S, et al. Understanding vaccination among hesitant adopters of the COVID-19 vaccine using the increasing vaccination model. J Health Commun. 2023;28(7):458-76.
- 30. Walsh MJ, Baker SA, Wade M. Evaluating the elevation of authoritative health content online during the COVID-19 pandemic. Online Inf Rev. 2023;47(4):782-800.
- 31. Burgess RA, Osborne RH, Yongabi KA, et al. The COVID-19 vaccines rush: participatory community engagement matters more than ever. Lancet. 2021;397(10268):8-10.
- 32. Wegwarth O, Hertwig R, Giese H, Fineberg HV. The impact of nontransparent health communication during the covid-19 pandemic on vaccine-hesitant people’s perception of vaccines. Front Public Health. 2024;11:1256829.
- 33. Petersen MB, Bor A, Jørgensen F, Lindholt MF. Transparent communication about negative features of COVID-19 vaccines decreases acceptance but increases trust. Proc Natl Acad Sci USA. 2021;118(29):e2024597118.
- 34. Miller FG. Liberty and protection of society during a pandemic: revisiting John Stuart Mill. Perspect Biol Med. 2021;64(2):200-10.
- 35. Kevat DA, Danielle CA, Pang SC, Dean JM, Farmer CC, Mahar PD. Medico-legal considerations of mandatory COVID-19 vaccination for high risk workers. Med J Aust. 2021;215(1):22-24.e1.
- 36. Amodio E, Restivo V, Firenze A, Mammina C, Tramuto F, Vitale F. Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients?. J Hosp Infect. 2014;86(3):182-7.
- 37. Stokel-Walker C. Covid-19: The countries that have mandatory vaccination for health workers. BMJ. 2021;373:n1645.
- 38. Cornuz J, Senn N. Faut-il rendre obligatoire la vaccination contre la grippe pour le personnel médical? Rev Med Suisse. 2011;7(319):2323-4.
- 39. Galanakis E, Jansen A, Lopalco PL, Giesecke J. Ethics of mandatory vaccination for healthcare workers. Eurosurveillance. 2013;18(45):20627.
- 40. Najera RF, Reiss DR. First do no harm: protecting patients through immunizing health care workers. Health Matrix. 2016;26:363-84.
- 41. Dawson A. Vaccination ethics. Public Health Ethics. 2011;4(1):143-53.
- 42. Caplan AL. Time to mandate influenza vaccination in healthcare workers. Lancet. 2001;378(9788):310-1.
- 43. Walsh JC, Comar M, Folan J, Williams S, Kola-Palmer S. The psychological and behavioural correlates of COVID-19 vaccine hesitancy and resistance in Ireland and the UK. Acta Psychol. 2022;225:103550.
- 44. R. c. Oakes. Décisions de La CSC. [1986] 1 SCR 103.